CSfPP Assessment Guidance V7 26th September 2014 Page 1
Consultation skills for pharmacy practice: Assessment Guidance
About this guidance
We’ve written this guidance to tell you more about the assessment and what it seeks to achieve, to remind you about the indicators that you will be looking
for in the assessment and to share the evaluation criteria that our team of assessors used when they were rating the videos that you watch. We think it’s a
good idea to read through the whole of this guidance; we know it’s quite long but we’ve tried to make it easy to read. If you just need to remind yourself of
the evaluation criteria however, you can click here to go straight to that page.
About this e-assessment
We have developed this assessment to support pharmacists and pharmacy technicians wherever they work in patient facing roles. Whilst each case is set in a
particular area of practice, you are evaluating the skills that are being used not the clinical knowledge.
It’s clear that good communication and consultation skills are essential for professional practice. But we rarely get the chance to watch other people in their
practice, or to be formally reviewed in our own. This assessment allows you the chance to watch a pharmacist in action, with a medical actor, and to make a
judgment on the skills that they display. Each video was reviewed by a team of pharmacists from across England, working in a range of practice settings.
Together they agreed whether the pharmacist was displaying poor, good or excellent consultation skills.
When you pass the assessment you can be assured that you have demonstrated an ability to recognise what makes practice good. Your challenge then will
be to make sure that this is the approach that you use when you are working with your patients. We are not looking for you to be hyper critical but at the
same time do not want you to have a nonchalant approach. You will need to apply your professional judgement. The approach we would like you to take is
as a critical friend. So, you are there to look for things which could be improved and recognise things done well. Record things as you watch. When you have
built up this ability to assess others you should then apply it to reflect on and develop your own practice.
CSfPP Assessment Guidance V7 26th September 2014 Page 2
The pharmacy professionals in the videos are real. They have been asked to demonstrate some skills, attitudes and behaviours which may not reflect their
daily practice. Many have found it difficult to include aspects of bad practice but you will see these demonstrated in some videos. We have also used
placebos and dummy tablet boxes in some shoots. The patients you see in the videos are medical role players (actors).
We recognise that this type of assessment asks you to make a judgement about what you see. Any type of judgement is subject to an element of
subjectivity. To reduce the impact of this, each video clip has been reviewed independently by a team of at least three assessors by applying an indicator
marking framework. We refer to these assessors as our panel throughout this guidance. We give you a copy of their evaluation framework, as you will be
making an assessment of the practice you see, in order to make the assessment fair (Appendix 1). The evaluation framework contains key skills and
behavioural indicators which reflect the national practice standards for pharmacy consultations. We recommend you print this, become familiar with the
content and use it as a reference source when working through the video observations.
Academic integrity
This assessment asks you to make a judgment on the skills that a pharmacist is demonstrating. As you are seeking to match the judgment that our panel
made, it’s important that you use the same evaluation criteria. Make sure that you keep a copy of the evaluation framework to hand to support you in
making your assessment. As you become more familiar with the indicators of poor, good and excellent practice, try and apply them to your own
consultations as well as the ones that you watch in this video.
The assessment is intended to be a true reflection of your personal abilities so you should use your professional judgement to ensure you find a quiet place
where you can work on your own without interruptions.
How the assessment works
The Consultation skills for pharmacy practice e-assessment is hosted on the CPPE website and you can find it at: www.cppe.ac.uk/assessment. There are four
sections to this e-assessment. You are allowed 30 minutes to complete each section so make sure you have enough time before you start each section.
Keep an eye on the timer in the top right hand corner. We recommend that you complete the sections in order from one to four. It will help you consolidate
your learning and each section builds on the one that precedes it. After attempting a section, you have to wait a day (20 hours) before you can try again.
We recommend that you use that time to read through the evaluation framework again and refer to the practice standards in the learning programme.
CSfPP Assessment Guidance V7 26th September 2014 Page 3
The pass mark for the first two sections is 80 percent. The pass mark for sections three and four is 60 percent. This reflects the fact that it is more difficult to
make an evaluation than it is to identify whether an action occurs. We tell you as soon as you finish the section whether you have passed it or not.
What the e-assessment looks like
There are four sections to the e-assessment. Here is an outline of each section; what the section looks like, what it assesses and top tips to support you
through the assessment section.
Section 1
Section 1 questions are knowledge and practice based and focuses on the following areas:
Medicines adherence and medicines optimisation
Practice standards
Consultation models
Consultation tools and frameworks for practice
Communication and consultation skills
The section contains 15 multiple choice questions. Each question has five possible answer options. You must choose the single best answer from the list.
There may be more than one answer which could be suitable; you have to choose the most appropriate answer.
Top tips to support you through section 1
Update your knowledge by working through the distance learning programme Consultation skills for pharmacy practice: Taking a patient-centred
approach.
If you are not successful in your attempt at section 1 you will be provided with some general feedback on areas of the assessment to revisit before
your next attempt
Have a copy of the distance learning programme to hand at the time of the assessment
CSfPP Assessment Guidance V7 26th September 2014 Page 4
Have knowledge of the national practice standards for pharmacy consultations and have a copy to hand
There may be more than one answer which is suitable, choose the most appropriate response
Sections 2, 3 and 4
These three sections all ask you to watch three video clips and assess them.
Section two asks you to state whether an indicator is demonstrated.
Section three lists five indicators which are demonstrated and asks you to evaluate how well they are done.
Section four lists five indicators. It asks if the indicator is demonstrated and, if so, asks you to evaluate how well it is done.
Sections three and four are more difficult as they ask you to make a judgment.
Video observation
In each of the three sections you will observe and assess three short video clips of a consultation. We know it is hard to sit and assess a full length
consultation so we have developed video clips of two to three minutes in length. The video clip will focus on one of the following areas of the consultation
although there may be some slight overlap in what you see in the clip. Here are the three different areas of the consultation you will see:
Part 1- The initial part of the consultation involving welcoming and setting scene of the consultation
Part 2- The middle part of the consultation where the pharmacy professional is gathering information, providing advice and information and pulling
together a shared plan
Part 3- The final part of the consultation where the pharmacy professional establishes agreement and ownership with the patient around a shared plan and
closes the consultation effectively
CSfPP Assessment Guidance V7 26th September 2014 Page 5
Indicators
The indicators have all been described in the core learning recommended to you in the ‘how will I improve or maintain my performance?’ area of this
website. We recommend you access and complete the core learning before attempting the assessment. The indicators in the assessment are those which are
most relevant to the part of the consultation you are assessing. However we have included additional indicators which could happen throughout the
consultation. The indicators are based on the national practice standards for pharmacy consultations and highlight the key knowledge, skills and behaviours
expected of all pharmacy professionals.
Assessing the video clip
Whilst watching the video clips, review the practice across the consultation you watch. Some skills could be demonstrated throughout, whilst others may
occur just at one point in the video clip.
In section 2 identify whether an indicator was demonstrated or not demonstrated by clicking onto the appropriate box.
In section 3 rate the demonstration of the indicator by choosing a number between 1 and 6 where 1 indicates poor practice and 6 indicates excellent
practice. Use the evaluation framework that we give you to make sure that you are applying the same standards and approach as our panel.
What do we mean by poor, good and excellent?
Poor practice - marking scale 1 to 2. You will see some elements of poor practice in the video clips. Think about the practice you see. If you feel
embarrassed to see a fellow professional act like this or demonstrate the skill in this way then it should be considered poor.
Good practice marking scale 3 to 4. Generally you will see opportunities to improve but there are some elements of good practice. There may be
inconsistencies in the practice of the pharmacist, but if this is the case you will see more good than poor to give a mark of 3 or 4.
Excellent practice marking scale 5 to 6. This represents practice where there may be slight room for improvement but on the whole this is practice you
would consider to be very good or excellent.
CSfPP Assessment Guidance V7 26th September 2014 Page 6
Top tips for working through sections 2, 3 and 4
Find a quiet place where you won’t be interrupted
Don’t focus on clinical information in the videos. We are assessing the consultation skills which are being demonstrated
Whilst watching the videos concentrate on the pharmacist and the skills, attitudes and behaviours they demonstrate
Rewind and watch the video several times to get a clear picture of what is demonstrated
Keep a notepad and pen at your side to record your thoughts
Print off and refer to the indicator marking framework in appendix 1 of this document
Use the full range of marks if it’s poor practice, give a ‘1’, if it’s excellent then give a ‘6’.
There were cases when we were reviewing these videos when we found it hard to gain agreement on the rating that we offered for the consultation skills.
Most of the reviewers watched a video three times in order to be sure of the type of questions that were asked, how open body language was
demonstrated, whether any bias or judgement was present and many other aspects of the consultation which make the difference between acceptable and
great practice. We recommend that you bear this in mind and watch the videos more than once to make these decisions for yourself.
In general, if you can’t think how the professional could have done it any better, then you will be giving them a top score. And hopefully you will find that at
least some of the practice that you see in the video clips deserves a top score.
CSfPP Assessment Guidance V7 26th September 2014 Page 7
Consultation skills for pharmacy practice: Indicator marking framework
The following examples of poor, good and excellent practice are used during the video review process. Please bear in mind that these are
examples to guide you in the assessment process and you will need to make your own professional judgement as to which number best
describes the practice you see demonstrated in the video (where 1 is poor and 6 is excellent). You will also recognise some overlap between
some of the indicators. Try to think of additional general points which would signify poor or excellent practice when addressing each indicator
such as tone of voice used and delivery of consultation (does it seem rushed or abrupt?).
Indicators more likely to occur in part 1 video clips
Does the pharmacy
professional?
Example of poor practice Example of good practice Example of excellent practice
Introduce themselves
and role
Begins the consultation with a
straightforward ‘hello’ or ‘hello I’m
the pharmacy technician’
Introduction which includes name
and role but could improve by using
a more welcoming tone and
establishing rapport by checking
patient name
Clear introduction with greeting, introduction by
first name and role using a welcoming tone of
voice. Also may check patient’s name and ask for
permission to call by first name if appropriate
Achieve consent
Community practice
Minimal explanation of the consent
process e.g. ‘Can I get your consent
for the consultation?’ and asks the
patient to sign the form without
obtaining verbal agreement from
patient
Gives an overview of the consent
process which may benefit from
clarification and obtains verbal
agreement (which could be a simple
‘ok’) and signature from the patient
which implies they understand
Gives a clear explanation of why consent is needed
and what it means (who the data will be shared
with and why) asks patient to confirm they
understand and obtains full agreement to the
process including signature, if required for a
service.
CSfPP Assessment Guidance V7 26th September 2014 Page 8
Achieve consent
Hospital practice
Gives a minimal description of why
the discussion is taking place whilst
obtaining vague agreement from the
patient e.g. ‘I’m just here to check on
your medicines, ok?’ The patient
may agree but use body language
which implies they don’t know why
the pharmacy professional is there.
Explains that they are part of the
patient’s care team, with a specific
role to look after the medicines.
Doesn’t gain agreement from the
patient or check their understanding.
Provides a clear explanation of why the discussion
is taking place which is followed by a discussion
gaining full agreement from the patient ‘Are you ok
with us going through each medicine now and you
can ask me any questions you want?’
Explain the planned
purpose of the
consultation
Provides a vague description of the
planned purpose e.g. ‘we’re here to
chat about your medicines’. May be
rushed and vague.
Provides a broader description of the
purpose of the consultation which
would benefit some clarity and does
not check patient understanding
Gives a clear yet concise description of the planned
purpose of the consultation, with an overview of
what it involves and the aims from the pharmacy
professional’s perspective and then checks patient
understanding e.g. ‘how does that sound to you?’
Establish the patient’s
agenda
May offer the patient an opportunity
to put forward their thoughts on
what they would like to achieve in
the consultation but done in a
disengaging manner (little eye
contact and frustrated tone) and few
words e.g. ‘anything else you think
we have to cover?’ The patient may
offer their own agenda, but if the
pharmacist has not invited it, then it
would be assessed as poor practice
Offers the patient an invitation to
put forward their agenda for the
consultation but may benefit from a
more engaging approach and
acknowledgement of this e.g.
‘anything else you want to chat
about?’
Gives an open invitation to the patient to put
forward their aim of the consultation and
acknowledges these e.g. ‘So, while we’re here is
there anything else that you’d like to discuss in the
consultation?’ The pharmacy professional may
record this information to confirm that the
patient’s agenda is considered. Also may change
the discussion to fit the patient’s agenda during
the consultation.
CSfPP Assessment Guidance V7 26th September 2014 Page 9
on their part. We’re assessing the
pharmacist, not the patient.
Negotiate a shared
agenda with the patient
Acknowledges the patient’s agenda
for the discussion but provides a
disengaging reply e.g. ’We can try
and discuss that later but I don’t
think we’ll have time’.
Acknowledges the patient’s agenda
for the discussion but prioritises own
agenda over the patient’s e.g. ‘I can
understand why that might worry,
we can discuss that later on’.
Talks through both the aims of the pharmacy
professional and patient and then negotiates
agreement on how the consultation will continue ‘I
can see you have concerns about your blood
pressure tablets, can I suggest we discuss those
first together before moving on to the rest of your
medicines, how does that sound?’
Establish the patient’s
use of their medicines
Asks an overarching closed question
to address all the medicines such as
‘are you taking all your medicines as
the doctor has prescribed them?’
Asks the patient about each
medicine using some open questions
but also includes some closed or
leading questions such as ‘your
simvastatin, you take this at night?’
Could improve practice by using
more open questions and
establishing if any doses are missed.
Uses an open approach which invites the patient to
provide the information and addresses each
medicine individually ‘tell me how you take your
simvastatin tablets’. Also encourages the patient
to talk about any issues with medicines use ‘people
often miss doses of their medicines for many
reasons. Have you found that with these tablets at
all?’
Establish the patient’s
understanding of why
they take their
medicines
Has more of a ‘telling’ approach
rather than asking the patient what
they know about their medicines e.g.
your simvastatin, you know that’s for
your high cholesterol, right?’
Establishes use of medicines using
mostly good practice by asking the
patient to describe how they take
their medicines but there may be
opportunities to improve by using
further open questioning techniques
Asks the patient to explain why they think they
have been prescribed a medicine eg; ‘your
simvastatin, tell me why the doctor prescribed that
for you’ and then confirms or corrects
understanding in a non-judgmental way
CSfPP Assessment Guidance V7 26th September 2014 Page 10
Indicators more likely to occur in part 2 video clips Does the pharmacy
professional?
Example of poor practice Example of good practice Example of excellent practice
Use open questions to gain
information from the patient
NB. Remember that the
patient may give a response
as if it was an open question.
You may need to listen
carefully.
May demonstrate the use of only
one example of an open question
in the whole consultation whilst
using closed or leading questions
for the main part of the
consultation when there is
opportunity to use an open
question to gain more information
Uses a mix of open and closed
questions throughout the consultation
and could improve by introducing
more open questions to the discussion
Uses open questions throughout the
consultation and gets a clearer picture from
the patient by following with more probing
questions at appropriate points. Only applies
closed questions at appropriate times to
confirm information.
Offer information in an
open, honest and unbiased
manner
Provides information to the
patient without first establishing
what the patient knows.
Information is given very much in a
‘telling’ and biased manner and in
such a way as to impose
recommendations on the patient
e.g. ‘The inhaler doesn’t cause any
side-effects, that’s a myth. It’s
really important you take it, what
you need to do is….’
Mainly offers information to the
patient in a balanced and unbiased
manner but could improve by
establishing the patient’s knowledge
prior to the information giving and
also providing a more balanced
approach which highlights benefits
and risks of action or behaviour
Establishes what the patient already knows
about their medicine/lifestyle issue/condition
and then asks what they would like to know
eg:’We could discuss some of the side-effects
of this medicine now if that would help?’
Offers the information in an unbiased and
balanced way describing both benefits and
risks of an action/behaviour when appropriate
Suggest different options for
the patient
Suggests a single option. If more
than one is suggested then is
dismissive of all but one
Offers the patient some options when
problem solving but does not engage
the patient in discussing the benefits
versus the risks of each option.
Offers the patient a range of options when
problem solving, outlining the benefits versus
the risks of these and engages the patient in a
discussion around these
CSfPP Assessment Guidance V7 26th September 2014 Page 11
Check patient understanding
of information offered
Makes minimal intervention to
ensure patient understands the
information offered such as stating
‘ok?’ following the information.
Checks with the patient at several
points within the discussion if the
information offered is understood by
asking questions such as ‘does that
make sense?’ Could improve by
checking if there have been any points
which the patient doesn’t understand
fully.
Checks with the patient throughout the
discussion if there have been any points which
they are not entirely clear about eg: ‘does that
make sense, is there anything which I haven’t
described very clearly that I can go over?’ May
in some instances ask the patient to repeat
some of the information back by relating it to
their own personal circumstances
Summarise information
provided
Provides a summary of the
information offered but this is
delivered in a rushed and abrupt
manner missing out some of the
main points of the consultation eg;
‘so, as discussed, take your
Ramipril in the evening from now
on’.
Provides a good summary of the
information offered but could improve
by including the patient as a partner in
the summary to gain shared decisions
and transfer of ownership of the plan
to the patient
Provides a clear and concise summary of the
discussion and information offered
throughout the consultation and relates this
to partnership working by using statements
such as ‘so far we’ve talked about the
problems you’ve been having with dizziness in
the morning and after discussing side-effects
of your medicines we both agree it will be
better for you to try and take the ramipril in
the evening to see if this helps solve the
problem’.
CSfPP Assessment Guidance V7 26th September 2014 Page 12
Indicators more likely to occur in Part 3 video clips Does the pharmacy
professional?
Example of poor practice Example of good practice Example of excellent practice
Agree a plan in partnership
with the patient
The pharmacy professional makes
all of the suggestions for the plan
and then checks with a simple
‘ok?’ There is no indication that
the patient has agreed, and may
be suggestions that the patient
does not. The ‘ok’ is more like
punctuation than an invitation to
engage.
The pharmacy professional engages
the patient in the planning and then
asks for general agreement from the
patient ‘so the best thing you can do is
set a quit date for next week. Does
that sound ok?’ There is no check that
the patient has buy in.
Engages the patient in problem solving and
decision making and formulating the plan in
partnership eg: ‘so we’ve established that you
do want to quit smoking and you’re happy to
set your quit date next Wednesday did you
say?’. …’then you said you’re happy to start
using the NRT patches on the same day and
come back here in ten days’ time’
Summarise the plan Provides a quick overview of the
plan which may be delivered with
emphasis on the fact that it is the
plan of the pharmacy professional
and not the patient. Delivers this
quickly with not much
engagement.
Summarises the plan accurately but
may sometimes deliver it as the plan
of the healthcare professional rather
than shared.
Gives a clear, concise overview of the
management plan moving forward whilst
putting emphasis on it being a shared plan.
Encourage the patient to
take ownership of plan
The pharmacy professional
describes the plan and then passes
ownership to the patient without
agreement e.g. So, I’ve explained
that you need to stop smoking
next Tuesday and you will start
using the NRT. That ok?’
The pharmacy professional describes
the plan and seeks agreement, but
doesn’t achieve it.
“You recognise that you need to stop
smoking and that NRT may work for
you. I’ve suggested you set your quit
Involves the patient in putting their ideas
forward for the plan. Facilitates the transfer of
the plan over to the patient and encouraging
them to take ownership by asking them to
reiterate the plan eg: ‘we’ve covered quite a
lot today. Just before we finish could you just
go over your plan of when you aim to stop
CSfPP Assessment Guidance V7 26th September 2014 Page 13
date for next Tuesday. OK?” smoking and what you’re going to do for
support during that time?’
Use closed questions to
confirm
information/conclude
Shows limited appropriate use of
closed questions to confirm
information established or
conclude but also gives many
examples of using closed questions
inappropriately
Shows some use of closed questions
to confirm information established or
conclude but could improve by less
inappropriate use of closed questions
such as establishing information
Uses closed questions appropriately and
efficiently to confirm information or conclude
the consultation eg: ‘you say you get
headaches every morning, have I understood
that correctly?’
Provide a safety net Offers the patient an opportunity
to come back but in a blasé fashion
eg: ‘you know where to find me if
you need to chat about anything’
Offers the patient an opportunity for
follow up in a set period of time.
Discusses a clear and concise contingency plan
with the patient should things not go entirely
to plan. This may include what could happen,
what to do if it does happen, who to contact,
how and when.
Bring the consultation to a
conclusion
Appears rushed at the end of the
consultation and concludes by
giving inappropriate statements
such as ‘sorry but I need to get
back to the dispensary now’ or
‘sorry but I need to see my next
client now’
Concludes the consultation effectively
but quite abruptly and could improve
by being more professional, thanking
the patient for their time and showing
interest in how the patient gets on
following the consultation
Concludes the consultation in a professional
and timely manner by thanking the patient for
their time, offering them the chance to come
back and speak at any time and asking them
to provide some follow up eg: ‘let me know
how you’re getting on next time you pop in’
CSfPP Assessment Guidance V7 26th September 2014 Page 14
Indicators you may see throughout the consultation Does the pharmacy
professional?
Example of poor practice Example of good practice
Display signs of open body
language
Shows some signs of open body
language but these are limited.
Breaks rapport by not maintaining
appropriate eye contact, sitting at
an angle to the patient and facing
a computer screen and also
displaying inappropriate facial
expressions. Showing one big sign
of closed body language will result
in a grade of poor. This action is
sure to break rapport for example,
leaning back in the chair, nodding
head and crossing arms in
judgment of information a patient
may give around smoking or
alcohol for example.
Mainly displays signs of good open
body language with only limited signs
of closed body language. Could
improve the balance by demonstrating
more open body language at points
and better use of responding to and
reflecting the body language of the
patient
Displays open-body language throughout such
as good eye contact, open and uncrossed
arms and legs and appropriate facial
expression. Also reflects and responds to the
body language of the patient appropriately by
remaining open when the patient shows
closed body language. Maintains open body
language when patients provide information
open to judgment such a high alcohol
consumption/smoking
Actively listen to the patient Shows few signs of active listening.
These may be limited to just the
occasional nod with no reflecting
and responding of information and
obvious neglect of verbal and non-
verbal cues
Shows some signs of active listening
for most of the consultation but may
improve by use of reflecting and
responding key points of information
and being more observant of verbal
and non-verbal cues
Shows signs of active listening throughout such
as good eye contact, acknowledging
information provided by the patient, reflecting
and responding key points of information and
picking up on verbal and non-verbal cues
Use clear concise language Although the use of clear language Shows use of clear and concise Shows a use of clear concise language
CSfPP Assessment Guidance V7 26th September 2014 Page 15
appropriate for the patient is evident throughout there are
numerous examples of the use of
jargon e.g. mdi, placebo,
bronchodilator). Information may
not be delivered clearly with risk of
patient not fully understanding
language for most of the consultation
with only one or two examples of
jargon. Information is mainly delivered
clearly
throughout and delivers information clearly.
Adapts the level of language to the patient in
the consultation to avoid patronising. Avoids
use of jargon (medical or otherwise).
Engage the patient in shared
decision making
Pharmacy professional makes the
majority of the decisions in the
consultation with very limited
patient engagement e.g. ‘what I
think you need to do is….ok?’
Engages the patient in the decision
making process mostly but may show
some signs of ‘telling’ the patient what
they think they should do before
getting agreement
Engages the patient fully in the decision-
making process whilst encouraging them to
form their own solutions e.g. ‘which of these
options do you think would work best for
you?’ ‘What would you like to try next?’
Record information Shows a disconnect of body
language whilst recording
information by turning away from
the patient, allowing the patient to
continue talking with only limited
acknowledgement of what they
are saying. May show occasional
nod whilst typing/writing.
Informs the patient that they are
going to record some information and
although this is done in a respectful
manner the consultation continues at
the risk of breaking rapport
Informs the patient that it may be necessary
to record information at points in the
consultation and at these points the pharmacy
professional may create a pause in the
discussion. This allows time for the patient to
reflect e.g. ‘that’s a really important point, I’ll
just stop for a second and make a note of it so
we don’t forget about it later’.
Invite the patient to share
ideas and concerns
What ideas do they have
about their medicines? What
are their worries?
Invites the patient to share ideas
and concerns but delivered in a
disengaging manner which actually
shows little interest or time for the
patients thoughts or worries
Invites and allows the patient to share
ideas and concerns but may not
always respond fully to the patient.
Could be improved by showing more
interest and follow up on these
thoughts and concerns.
The pharmacy professional is very proactive in
engaging in a discussion about ideas and
concerns the patient may have and invites
them openly to discuss these and follows
them up eg: ‘do you have any worries about
your medicines?’ ‘What are your feelings
CSfPP Assessment Guidance V7 26th September 2014 Page 16
towards your medicines?’
Demonstrate a non-
judgemental and respectful
attitude
Patients may sometimes
have their own thoughts and
beliefs which may or may not
be accurate. They may
describe behaviours you may
not be entirely comfortable
with.
Demonstrates some non-
judgmental behaviour but this is
mainly over-shadowed by an
episode or episodes of judgmental
behaviour which could break
rapport
Demonstrates a non-judgmental and
respectful attitude mainly throughout
the consultation but may show a slight
indication at a specific point which
could be interpreted as judging the
patients behaviour or beliefs. This
could be a verbal or non-verbal
demonstration.
Demonstrates a non-judgmental attitude
throughout the consultation, picks up on a
patients non-verbal cues if they are
embarrassed or uncomfortable when talking
about sensitive issues and makes a positive
effort to put the patient at ease when
discussing issues which could potentially make
the patient feel as though they have done
something wrong e.g. non-adherence.
Show empathy when dealing
with patient’s emotions and
concerns
Patients may sometimes
describe difficult events in
their lives
Attempts to be empathetic but
appears uncomfortable and tries
to move the discussion on quickly
e.g. ‘I’m sorry about that, let’s see
what we can do to sort these
tablets out’. May also use
inappropriate methods which
undermine the patient’s feelings
for example relating the patient’s
situation to a similar event in their
own life ‘I know what you’re going
through as I lost my mum just a
few years ago. It’s a terrible
feeling, I felt lost but I’m ok now’.
Makes a good attempt to demonstrate
empathy by acknowledging the
patients situation but may show
slightly inappropriate responses such
as displaying sympathy.
Fully acknowledges the patient’s situation and
responds appropriately with empathy when a
patient describes a difficult event in their life.
Avoids sympathy and does not relate the
patient’s situation to their own personal
experience. E.g. I’m so sorry for your loss, it
must be a difficult time for you. Would it help
to talk a little bit more about that?
CSfPP Assessment Guidance V7 26th September 2014 Page 17
Raise the issue of healthy
lifestyle choices
Raises the issue of healthy lifestyle
choices inappropriately as a quick
add on (this could be whilst writing
up notes) e.g. ‘I haven’t got much
time left but we’d better have a
quick chat about lifestyle while
you’re here’
Raises the issue of healthy lifestyle
choices with the patient at an
appropriate point but may not explain
the purpose of raising the issue.
Raises healthy lifestyle issues appropriately
and confidently without making the patient
feel uncomfortable and whilst being respectful
of the patient’s time eg: while you’re here we
are looking at ways to support our patients in
making healthy lifestyle choices. This can have
great benefits in reducing the chances of
cancer, diabetes and heart disease. Is that
something we could chat about now?’
Engage the patient in a
discussion about health
lifestyle choices
Offers a very half-hearted and
rushed discussion as if it is just a
tick-box exercise. Does not provide
follow up or additional
information. Conversation may be
one-sided with the pharmacy
professional making the
assumption that the patient wishes
to change behaviour.
Discusses but may appear to do this
half-heartedly or a little rushed at
some points. Establishes patients
current behaviours but may improve
by having a more proactive approach
and offering a joint discussion about
potential change
Engages in the discussion in a respectful
manner whilst gaining the patients
understanding of what healthy lifestyle choices
are and what their current behaviours are.
Discusses the benefits of making change,
offers constructive support and is respectful of
patient’s views. Offers opportunity for follow
up and additional information to take away.
Provide an opportunity for
the patient to ask questions
Offers an opportunity to ask
questions but done abruptly or in a
rushed manner which really says
‘please don’t ask me any
questions, I haven’t got time’
Openly offers an opportunity in the
consultation for the patient to ask
questions
Openly encourages the patient to ask
questions throughout the course of the
consultation e.g. is there anything you’d like
to ask at this point?’
CSfPP Assessment Guidance V7 26th September 2014 Page 18
Feedback
As you have read through these indicators we anticipate that you will have noticed the following general rule.
Poor practice – It may be there, but if so the pharmacist is dismissive and does it because they have to, rather than showing that they want to.
Good practice – Normal practice. Sometimes gets things wrong, but tries to cover the issues and discuss what’s needed with the patient.
Excellent practice – Engages the patient. Repeated efforts to find out the patient’s concerns, listen to them, take their views into account and build the
consultation around them.
We do want to make this guide as useful as possible for you, to help you recognise great consultation skills and to apply them in your own practice. So, if
you have questions, or suggestions, on how we can improve this guide, then please get in touch with us using [email protected]. We plan to repeatedly
review this assessment and how it operates, taking your thoughts and feedback into account. If you don’t tell us what works, or doesn’t work, for you then
we can’t make it as good as our profession needs.